The Media's Year In Health Care Coverage

2013 will be remembered as the year of health care policy. The Affordable Care Act (ACA) dominated media outlets across the spectrum, especially following the implementation of the law's health care exchanges in October. Yet often lost in all the noise was factual reporting on the new law. Much right-wing and even mainstream media coverage pushed misleading, hyperbolic, and outright false attacks about the ACA.

Inflammatory Rhetoric

In an October 11 appearance at the Values Voters' Summit, recently-hired Fox News contributor Dr. Ben Carson declared that Obamacare "is the worst thing that has happened in this nation since slavery," later deciding, "It is slavery, in a way." Carson's comparison of slavery to a law that grants universal access to health insurance was not remarkable for the right-wing media. In an appearance on NPR's Morning Edition, George Will approved of GOP efforts to repeal the law by likening them to the Fugitive Slave Act, saying "the Fugitive Slave Act was the law, separate but equal was the law, lots of things are the law and then we change them." On Fox News' Hannity, right-wing radio host Hugh Hewitt compared defunding the ACA to repealing prohibition and slavery.

Conservative media were not the only ones to make outrageous comparisons. Media figures across the ideological spectrum attempted to link technical problems with Healthcare.gov to the Bush administration's botched response to Hurricane Katrina. The comparison, of course, ignores the thousands of lives lost in the hurricane, as Media Matters pointed out:

Unbalanced Coverage

Coverage of the ACA was marked by mainstream media outlets overwhelmingly hyping negative aspects of the law's rollout while downplaying positive consequences and stories. A Media Matters study of October and November found that 68 percent of ACA stories in evening news programs on ABC, CBS, and NBC were negative, while 32 percent were a mix. Only CBS Evening News with Scott Pelley aired positive stories. But even in the case of CBS, only 10 percent of the stories were positive, compared with 46 percent being negative and 44 percent being mixed.

The lack of positive coverage of the ACA's consequences is not due to a lack of opportunity. Despite problems accessing the website, in the weeks following the rollout of the exchanges many people were provided the opportunity to access affordable health care coverage. The law's protections for people with pre-existing conditions expanded access and lowered costs for many health care consumers who had previously been denied coverage. A New York Times article momentarily broke the trend of negative stories when it highlighted four stories of people who had previously been turned down for coverage or had to make financial sacrifices to pay for insurance due to pre-existing conditions until the exchanges opened:

The rollout of the health care law has been plagued with problems so deep that even some of its strongest supporters have soured on its potential. The bottlenecks in the federal online insurance exchange, which serves 36 states; the cancellation of hundreds of thousands of policies that did not comply with the minimum requirements of the new law; and the high price of some plans sold through both federal and state-run exchanges have all cast a pall over President Obama's efforts to win support for the law.

But for all those problems, people are enrolling. More than 243,000 have signed up for private coverage through the exchanges, according to the Kaiser Family Foundation, and more than 567,000 have been determined eligible for Medicaid since the exchanges opened on Oct. 1. For many, particularly people with existing medical conditions like Mr. Acosta, the coverage is proving less expensive than what they had. Many others are getting health insurance for the first time in years, giving them alternatives to seeking care through free clinics or emergency rooms -- or putting it off indefinitely.

Collapse Of The Obamacare "Horror Stories"

In lieu of providing balanced coverage of the law's effects, both right-wing and mainstream media outlets turned to highlighting stories of people who claimed to be negatively impacted by the law. These stories not only painted a misleading picture of the law's effects, they often were outright false. Sean Hannity, for instance, dedicated a special edition of his Fox News program to hosting three couples who all purported to be victims of the ACA. Yet after the segment aired, Eric Stern, a former senior adviser to Governor Brian Schweitzer of Montana, contacted each of the couples and found that none of them had actually been negatively impacted by the law, nor had they even visited the insurance exchanges to discover the options that the law would provide them. Stern presented his investigation in an October 18 article in Salon:

First I spoke with Paul Cox of Leicester, N.C. He and his wife Michelle had lamented to Hannity that because of Obamacare, they can't grow their construction business and they have kept their employees below a certain number of hours, so that they are part-timers.

Obamacare has no effect on businesses with 49 employees or less. But in our brief conversation on the phone, Paul revealed that he has only four employees. Why the cutback on his workforce? "Well," he said, "I haven't been forced to do so, it's just that I've chosen to do so. I have to deal with increased costs." What costs? And how, I asked him, is any of it due to Obamacare? There was a long pause, after which he said he'd call me back. He never did.

Less egregious but still irresponsible anecdotal coverage of the ACA occurred in other media outlets. A CBS This Morning segment highlighted Dianne Barrette, a woman who claimed to be satisfied by her current coverage and unwilling to pay more for another plan under the exchanges. But as Eric Wemple of the Washington Post pointed out, Barrette's previous coverage was a "pray-that-you-don't-get-sick" plan that "could well have bankrupted her." CBS left out the inadequacies of Barrette's current plan in its profile of her. In fact, in a follow-up to CBS' story, The New Republic contacted Barrette who said "she's no longer aghast at losing her plan--and curious to see what alternatives are available. 'Maybe,' she told me, 'it's a blessing in disguise.'"

The media's tendency to use negative "exemplars" in health care coverage overstresses negative consequences of the law, as Paul Waldman explained in an American Prospect post:

As the Affordable Care Act approaches full implementation, we're seeing a lot of exemplar stories, and I've been noticing one particular type: the story of the person who seems to be getting screwed. If it were true that most Americans were indeed being made worse off by the law, that would be a good thing; we'd learn their stories and get a sense of the human cost of the law. The trouble is that in the real world, there are many more people being helped by the law than hurt by it, and even those who claim to be hurt by it aren't being hurt at all.

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Journalists have a natural inclination to cover bad news over good and to be skeptical of the government, which is usually healthy. But if you aren't careful it can also lead to misleading reporting. If you're going to do a story presenting one person as a victim of the law, it might be a good idea to make sure they are what you say they are.

The Media-Led Repeal Campaign

Prior to the rollout of the exchanges, Republicans in Congress attempted a series of last-ditch efforts to repeal or defund the law. Conservatives in the media, and particularly on Fox, provided on-air support for these efforts. Sean Hannity applauded Sen. Ted Cruz (R-TX) for his defunding efforts, providing him a platform to advocate for his anti-health care agenda. Hannity cheered on the senator, saying, "I applaud your efforts. I'm with you in this. To me, this is a tipping point for the country." Fox News Radio host Todd Starnes said anything short of the GOP defunding Obamacare "is a betrayal to the people who sent them to Washington, D.C."

Conservative media figures ramped up their rhetoric during the budget debate in August and September, arguing that shutting down the government over the fight to defund the ACA is "the right thing to do" and demanding that House Republicans hold the line in budget negotiations. The GOP acquiesced, and on October 1, the federal government shut down for several weeks, costing the economy billions of dollars, slowing growth of the gross domestic product, decimating consumer confidence, placing hundreds of thousands of federal workers on furlough, and harming small businesses that rely on government contracts.

The Ongoing Right-Wing Media Disinformation Campaign

While health care coverage in the last three months of 2013 was dominated by talk of the exchange implementation, right-wing media spent the majority of the year pushing a slew of false and misleading claims about Obamacare. Conservative media resurrected zombie lies about the ACA, including the claim that the law includes "death panels," while also inventing new falsehoods about the law. Here are some of their favorites: